German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich (LMU), Munich, Germany.
Department of Ear, Nose, Throat and Facial Surgery, Interdisciplinary Center for Vertigo and Neurological Visual Disorders, University Hospital Zurich, Zurich, Switzerland.
J Vestib Res. 2023;33(5):349-361. doi: 10.3233/VES-220122.
Vestibular rehabilitation therapy (VRT) is effective for most patients with dizziness and imbalance. Home exercise programs are widely used. It is unknown, however, how specific the instructions for exercises have to be.
To evaluate the effects of expert assessment and instructions in a booklet-based home VRT program for patients with chronic dizziness.
Randomized controlled study on 74 participants with disabling dizziness for >3 months. All study participants received a booklet-based VRT for training at home. Participants were prescribed 20 minutes of exercise, twice a day. The intervention group (n = 37) received specific instructions (expert physiotherapist). The control group (n = 37) practiced without specific instructions. Primary outcome was the total score of the Dizziness Handicap Inventory (DHI-G). All outcomes were assessed at baseline, after 4 weeks, and at follow up 4 weeks later.
Both groups improved (DHI-G 43.94±18.89 at inclusion to 33.06±19.67 at follow-up in controls and 42.82±16.60 to 22.65±19.12 in the intervention group). The intervention group, however, improved more (p = 0.014).
We show a significant effect of expert physiotherapy guidance in home-based VRT. This strengthens the role of the physiotherapist in VRT: Tailored, personalized instructions are needed to get the best effect of VRT.
前庭康复治疗（VRT）对大多数头晕和平衡障碍患者有效。家庭运动方案被广泛应用。然而，对于运动的具体指导要求尚不清楚。
评估基于手册的家庭 VRT 方案中专家评估和指导对慢性头晕患者的影响。
对 74 名有 3 个月以上致残性头晕的参与者进行随机对照研究。所有研究参与者均接受基于手册的 VRT 家庭训练。参与者每天练习两次，每次 20 分钟。干预组（n=37）接受了具体的指导（专家理疗师）。对照组（n=37）则在没有具体指导的情况下进行练习。主要结局是眩晕障碍量表（DHI-G）的总分。所有结局均在基线时、4 周后和 4 周后随访时进行评估。
两组均有改善（对照组的 DHI-G 评分从纳入时的 43.94±18.89 降至随访时的 33.06±19.67，干预组从 42.82±16.60 降至 22.65±19.12）。然而，干预组的改善更显著（p=0.014）。
我们发现家庭 VRT 中专家理疗指导有显著效果。这加强了理疗师在 VRT 中的作用：需要个性化、量身定制的指导，以获得 VRT 的最佳效果。
